Managing Diabetes During Ramadan – by Mohammad Y. Al-Bahar

With Ramadan drawing to a close, Mohammad from Kuwait shares his experiences on managing diabetes while fasting during this holy month. Please remember that the content in this Global Postcard is not intended to replace advice from your healthcare professional. Diabetes is different for everyone, so it’s important to chat with your healthcare professional for advice that is right for you. 

Not sure where to start the conversation with your healthcare professional? Check out the International Diabetes Federation practical guidelines on diabetes and Ramadan here.

Since it is considered one of the five pillars of Islam, Ramadan is a month when Muslims fast from having food and drinks (including water) from sunrise to sunset. The main purpose of fasting is to have inner discipline, and to understand how poor people feel, and to be able to give to those in need. 

People living with diabetes around the globe fast during this holy month – including here in Kuwait – although they are not obliged to fast. If they are not fasting, they have the option to give away an amount of money as a form of charity for an individual who is fasting during the full duration of the holy month. 

If you tend to have frequent high or low blood sugars, doctors and healthcare professionals will suggest that you avoid fasting. If you are living with type 1 diabetes and willing to fast, it is important to always consult your doctor before fasting. Doctors and healthcare professionals may suggest these considerations:

Try to stick to a healthy meal plan with a low percentage of fat and full of fiber and protein. Divide meals into three to five meals a day (three meals and two snacks), as this will help avoid hunger and maintain better sugar levels. 

Be sure to check BG levels every two hours to check for high or low blood sugars. It is recommended that sugar levels should be 7-10 mmol/l during the fasting period. If your sugar levels are below 6 mmol/l, doctors and healthcare professionals will suggest you to stop fasting and treat your BG if it goes lower. If BG levels are above 10 mmol/l, check for ketones; if positive for ketones, it is suggested that you should stop fasting, take a correction dose and drink water.  

It is important to always have your hypo kit handy during Ramadan, along with other essential diabetes supplies such as your BG testing device and medical ID, just in case your blood sugar drops while you are on the go. 

Healthcare professionals and doctors may recommend a light workout before the eftar, which is also called futoor, iftar or fatoor, (the last meal before fasting, which is before dawn), such as walking, pilates, or yoga. They also generally recommend saving extensive sports for after the eftar (the first meal after the fasting, which is usually during the dusk period), not before, to avoid hypos or hypers. 

As a person living with diabetes, I reduce my consumption of desserts and food that contain high percentage of fat, avoid having big portions of food during suhoor (otherwise known as suhur or sahur) meal, and avoid having plenty of coffee and tea during suhoor meal. Some foods that I eat during suhoor meal: brown bread; hummus and broad beans (fava beans); fruits such as bananas, oranges and apples; fresh vegetables, as well as a small portion of nuts such as almonds. 

While having the futoor meal, doctors and healthcare professionals would generally recommend to have one or two dates, along with some liquids such as water or soup. While taking any medication along with this meal, they also suggest 15- to 20- minute pause and resume having your meal afterwards. 

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